A dependent child may become eligible for coverage by way of a QMCSO. If approved, coverage will become effective as of the date specified in a judgment, decree or order issued by a court of competent jurisdiction or through a state administrative process. The order must clearly identify all of the following:
The name and last known mailing address of the participant;
The name and last known mailing address of each alternate recipient (or official state or political designee for the alternate recipient);
A reasonable description of the type of coverage to be provided to the child or the manner in which such coverage is to be determined;
A statement that the child has the right to receive health benefits for which you are eligible; and
The period to which the order applies.
A participant must submit a Medical Child Support Order to the group health plan Plan Administrator to determine whether it is qualified, and thus a QMCSO. A copy of the written procedures that the Plan uses when administering Qualified Medical Child Support Orders may be requested from Plan Administrator, at no charge.